Discussion Topic: Obesity and Diabetes
A 48-year-old woman presents with a chief complaint of knee pain, with aching and stiffness on arising but easing up during the day. She does not engage in any type of exercise or activity. She is a grava 4, para 4 with a 10-year history of hypertension and a diagnosis of diabetes in the past 2 years. She calls it “sugar” and states that this condition is controlled with diet. She recently began working at a local Wal-Mart and has had to assist with shelving and loading of boxes.
CC: “My knee really hurts.”
Physical exam: Blood pressure, 154/94; pulse rate, 88 beats/min; respiration rate, 20/min. Afebrile. Height, 5΄3΄΄; weight, 215 lbs. Her body mass index is 29. The exam is remarkable for obesity and an erythematous rash under both breasts and in the groin. Her knee is tender and swollen. This patient is not new to your practice but it is the first time that you have seen her. She lives with her husband, who is also overweight.
Current medications: None
- How will you manage this complex patient? What health promotion strategies are especially important for this patient at this point in time and WHY?
- What Healthy People 2020 objectives are relevant?
